FORM 1023-EZ for TBA IMMIGRANT COMMUNITY SERVICES

Field Data
EIN 81-3866047
Case Number EO-2016305-000126
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TBA IMMIGRANT COMMUNITY SERVICES
Organization’s Mailing Address 1707 17TH AVENUE SOUTH
City SEATTLE
State WA
ZIP 98144
Accounting period End 12
Primary contact name TESHOME BAYU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TESHOME BAYU
PRESIDENT/DIRECTOR
1707 17TH AVENUE SOUTH
SEATTLE WA 98144

Officer/Director/Trustee Two

DESTA TEFERA
SECRETARY/DIRECTOR
148 SW 153RD ST 201
BURIEN WA 98166

Officer/Director/Trustee Three

JOHN ROBERTSON
BOARD MEMBER
7102 230TH ST
MOUNT LAKE TERRACE WA 98043

Organization’s website
Organization’s email TESHOMEB3@AOL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/20/2016
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P84 - Ethnic, Immigrant Centers, Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
One Third Support Public No
One Third Support Gifts No
Benefit of College Yes
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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